The allegations were originally brought in a lawsuit filed by a former Arch Health employee. The employee accused Arch Health, which contracts with physician groups to provide care through Escondido, Calif.-based Palomar Health, of erroneously billing Medicare for services that weren’t sufficiently documented. The employee filed her case under the qui tam whistleblower provision of the False Claims Act, and will share in $183,830 of the settlement.
Based on self-disclosures by Arch Health, federal officials also alleged that the group paid referring physicians and physician groups above fair market value, thereby violating the Anti-Kickback Statute, Stark Law and the False Claims Act.
More articles on legal and regulatory issues:
Former VA employee sentenced to federal prison for wrongfully accessing coworkers’ medical records
3 Texas health systems settle lawsuit alleging they colluded to stifle nurse pay
Supreme Court will not expedite review of ACA constitutionality
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.